摘要
目的评价理气合胃方加减结合西医常规疗法治疗Hp阳性慢性浅表性胃炎(chronic superficial gastritis,CSG)的临床疗效。方法将符合入选标准的2017年1月—2019年1月连云港市第一人民医院和常熟市第一人民医院96例Hp阳性CSG患者,按随机数字表法分组为2组,每组48例。对照组予西医常规疗法治疗,研究组在对照组基础上加服理气合胃方加减治疗。2组均治疗8周,随访12周。分别于治疗前后进行中医症状评分及胃黏膜和病理分级评分;采用免疫比浊法检测促胃动素、促胃液素和生长抑素水平,采用全自动流式细胞仪检测CD3^(+)、CD4^(+)、CD8^(+)水平,计算CD4^(+)/CD8^(+)比值;观察Hp转阴率,记录不良反应,评价临床疗效,统计复发率。结果研究组Hp转阴率为89.6%(43/48)、对照组为72.9%(35/48),2组比较差异有统计学意义(χ^(2)=4.376,P=0.036)。研究组总有效率为95.8%(46/48)、对照组为83.3%(40/48),2组比较差异有统计学意义(χ^(2)=5.031,P=0.025)。研究组治疗后胃脘痛、上腹饱胀、反酸、嗳气、纳差食少评分低于对照组(t值分别为8.919,3.971,7.949,8.171,9.865,P值均<0.01);胃黏膜与病理分级评分低于对照组(t值分别为13.705,15.495,P值均<0.001)。治疗后,研究组促胃液素[(126.15±14.36)ng/L比(152.38±17.51)ng/L,t=8.025]、促胃动素[(93.59±11.87)ng/L比(102.48±14.68)ng/L,t=3.263]、生长抑素[(36.76±8.97)ng/L比(40.84±10.68)ng/L,t=2.027]水平低于对照组(P<0.01或P<0.05);CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)比值高于对照组(t值分别为6.883、6.720、4.306,P值均<0.001)。研究组复发率为4.3%(2/46)、对照组为17.5%(7/40),2组比较差异有统计学意义(χ^(2)=3.950,P=0.046)。治疗期间,研究组不良反应发生率为8.3%(4/48)、对照组为12.5%(6/48),2组比较差异无统计学意义(χ^(2)=0.446,P=0.504)。结论理气合胃方加减结合西医常规疗法可有效改善Hp阳性CSG患者的胃肠激素水平及临床症状,提高免疫力及Hp转阴率,降低复发率。
Objective To evaluate the clinical efficacy of modified Liqi-Hewei Decoction combined with conventional western medicine therapy in the treatment of Hp-positive chronic superficial gastritis(CSG).Methods A total of 96 patients with Hp-positive CSG in the First People’s Hospital of Lianyungang and Changshu No.1 People’s Hospital who met the inclusion criteria between January 2017 and January 2019 were divided into two groups according to the random number table method,with 48 in each group.The control group was treated with conventional western medicine,and study group was additionally given modified Liqi-Hewei Decoction on the basis of control group.Both groups were treated for 8 weeks and followed up for 12 weeks.The TCM symptom score,gastric mucosa and pathological grading were scored before and after treatment.Levels of motilin,gastrin and somatostatin were detected by immunoturbidimetry,and levels of CD3^(+),CD4^(+)and CD8^(+)were detected by automatic flow cytometry and the ratio of CD4^(+)/CD8^(+)was calculated.The Hp negative conversion rate was observed,the adverse reactions were recorded,the clinical efficacy was evaluated and the recurrence rate was statistically analyzed.Results The Hp negative conversion rate was 89.6%(43/48)in study group and was 72.9%(35/48)in control group,where the difference was statistically significant(χ^(2)=4.376,P=0.036).The total effective rate was 95.8%(46/48)in study group and was 83.3%(40/48)in control group(χ^(2)=5.031,P=0.025).After treatment,the scores of epigastric pain,upper abdominal fullness,acid reflux,belching and poor appetite in the study group were significantly lower than those in control group(t=8.919,3.971,7.949,8.171,9.865,all Ps<0.01).The scores of gastric mucosa and pathological grading were significantly lower than those in control group(t=13.705,15.495,all Ps<0.001).After treatment,the levels of gastrin[(126.15±14.36)ng/L vs.(152.38±17.51)ng/L,t=8.025],motilin[(93.59±11.87)ng/L vs.(102.48±14.68)ng/L,t=3.263]and somatostatin[(36.76±8.97)ng/L vs.(40.84±10.68)ng/L,t=2.027]in the study group were significantly lower than those in the control group(P<0.01 or P<0.05).The levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were significantly higher than those in the control group(t=6.883,6.720,4.306,all Ps<0.001).The recurrence rate was 4.3%(2/46)in the study group and was 17.5%(7/40)in the control group(χ^(2)=3.950,P=0.046).During treatment,the incidence rate of adverse reactions was 8.3%(4/48)in the study group and was 12.5%(6/48)in the control group(χ^(2)=0.446,P=0.504).Conclusion Modified Liqi-Hewei Decoction combined with conventional western medicine therapy can effectively improve the levels of gastrointestinal hormones and clinical symptoms,enhance the immunity and Hp negative conversion rate,and reduce the recurrence rate of patients with Hp-positive CSG.
作者
李晓玥
程军
俞仲贤
金仲达
Li Xiaoyue;Cheng Jun;Yu Zhongxian;Jin Zhongda(Department of Traditional Chinese Medicine,the First People’s Hospital of Lianyungang,Lianyungang 222000,China;Department of Traditional Chinese Medicine,Changshu NO.1 People's Hospital,Changshu 215500,China)
出处
《国际中医中药杂志》
2021年第10期981-985,共5页
International Journal of Traditional Chinese Medicine
关键词
幽门螺杆菌
慢性浅表性胃炎
理气合胃方
促胃动素
促胃液素
中西医结合疗法
Helicobacter pylori
Chronic superficial gastritis
Liqi-Hewei Decoction
Motilin
Gastrin
Integrated Chinese traditional and western medicine therapy
作者简介
通信作者:程军,Email:1355161670@qq.com。
